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    Healthcare Plan Information

    Dean Health Plan Patient Safety Initiatives

    Dean Health Plan (DHP) is committed to providing its members with safe health care. Patient safety has been defined as those care and intervention practices that reduce actual and potential risks contributing to accidental patient injury or unintended adverse patient outcomes across a range of diagnoses or causes. Threats to patient safety can occur in all health care settings and stem from a wide variety of causes. These risks may result in significant iatrogenic mortality or morbidity and increase financial costs to both patients and health care organizations.

    The Institute of Medicine (IOM) report suggesting that 44,000 - 98,000 Americans die each year as a result of medical errors produced new interest in the importance of patient safety on the part of patients and practitioners. Research has shown that inefficiencies and deficiencies in the health care system itself, rather than carelessness or poor caregiver performance, are often most responsible for risks to patient safety. For this reason, DHP's approach to improving patient safety centers on assisting practitioners and members in recognizing potential risks, identifying contributing systemic and human factors, and determining the systemic changes necessary to mitigate risk.

    During 2003, DHP established a Patient Safety Work Group focusing on all organizational efforts that identify and reduce actual and potential risks contributing to accidental patient injury or unintended adverse patient outcome. The mission of the Patient Safety Work Group is to identify and address the patient safety requirements of members, practitioners, and purchasers in a timely and responsive manner. This allows DHP to pursue a comprehensive patient safety plan that addresses ambulatory care, inpatient care, pharmaceutical use, and member actions.

    The Patient Safety Work Group has identified the following objectives for 2003-2004:

    • Developing a practitioner education strategy, including the timelines and named persons responsible, designed to educate and inform contracted practitioners and providers about patient safety and opportunities for improvement
    • Educating members and practitioners about means and value of improving patient safety, specifically as it relates to reducing the likelihood of preventable medical errors
    • Encouraging practitioners in ambulatory care (i.e., clinics or physician offices) and inpatient settings to take an active role in improving patient safety

    DHP has taken an active role in identifying and preventing medication errors. One way DHP achieves this is by providing plan pharmacies with information about potential drug interactions at the time prescriptions are filled. Members' prescriptions histories are evaluated to determine the potential for adverse drug interactions and information is provided to the pharmacist to prevent such occurrences.

    Patient safety also is one of the topics discussed with practitioners during biennium site visits. These discussions allow DHP to better understand the patient safety improvement initiatives already underway at practitioner sites and offers opportunities to share information about other means of improving the care received by DHP members.

    In addition to the patient safety initiative objectives described above, DHP seeks to reduce unintended adverse patient outcomes by improving the quality of care received by DHP members.

    Preventive Health

    DHP participates in the development and distribution of health maintenance guidelines to identify those tests and services that have been demonstrated to improve preventive health care. Health maintenance guidelines focusing on children (i.e., pediatrics), adults, and prenatal/postpartum care are currently available. Each of these guidelines is based on scientific evidence that is reviewed at least every two years. Guidelines are distributed to all plan primary care practitioners and members are provided with information about these recommendations though member newsletter articles and targeted member mailings.

    Chronic Illness

    In an effort to insure that members receive high-quality, cost-effective health care, DHP has implemented Health Management Systems (HMS) for members diagnosed with certain chronic conditions. DHP's Health Management Systems (HMS) are designed to address chronic conditions relevant to our membership for which there is documented scientific information for improving outcomes.

    Approximately 3.5 % of DHP members have been diagnosed with diabetes and approximately 11% of all members have been diagnosed with hypertension. Given the prevalence of these two conditions, DHP has established Diabetes HMS and Hypertension HMS programs. The scope of these programs is broad and includes a range of care and services that address the issues of living with chronic illness.

    DHP members are the primary focus of the HMS programs. Members' knowledge and active participation in managing their care has been demonstrated to play a critical role in improving clinical outcomes and quality of life. DHP's HMS programs capitalize on this by providing members with important information about their illness and the care that has been demonstrated to reduce the likelihood of future complications.

    DHP also works to insure that practitioners have access to the information necessary to provide members diagnosed with diabetes and hypertension with the highest-quality and most cost-effective care. One way DHP has achieved this is through the development and dissemination of clinical guidelines. These guidelines highlight those routine services (e.g., HbA1c testing, lipid testing, blood pressure monitoring) and treatments that have been demonstrated to improve care. Practitioners are routinely provided with feedback regarding their adherence to these recommendations as a means of monitoring member care and identifying future opportunities for improvement.

    Providing safe, high-quality, and cost-effective health care is one of the primary goals of DHP. For this reason, DHP remains dedicated to participating in those activities that reduce actual and potential risks contributing to accidental patient injury or unintended adverse patient outcomes and that enhance the quality of services received by DHP members. Information about DHP's patient safety initiatives, and efforts to achieve the objectives outlined above, is regularly shared with members and practitioners through provider and member newsletter articles and web updates (see www.deancare.com/healthplan/Quality).

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